3819 Laurel Ct4101 City of Btu
3830 Pilot Knob Road
Eagan MN 56122
Phone: (651) 675-5875
Fax: (651) 6754694
Use BLUE or BLACK Ink
For Office Use
Pend rk 0 p(10
Permit Fee:
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:) r site Address: T S'/ 9 L79 Li 2 L G7-. _ unit*:
Retiideltt/
Qwner
TYPeWAYork,
Contractor
Name: CA, 4e) %%l44 A 6 £ /K £ ..3 T.2 ., c. Phone: 763 - r5-1- 9 h 7
Address 1 City / Zip: 8S0 E Corry Q /9 v. A , ,2! A 6 06 6 14441 r /nA)
SS'qz 7
Applicant is: Owner ,Contractor
Description of work: 2 Pi 4 C L m u ri P L LA), „> p u L'•••
Construction Cost, Multi -Family Building: (Yes, 1 No
Company: L i / 0 2 Midi/4-r _ Colt Contact b4,/, rS d3,lz-2i S
Address: 6/os- L l00�' J%
State: /VAS Zip: 5-5.-.1// 9
City: /Yi PL
Phone: 6oi2` 840/-!024/3
License #: 4• L 2 Y/ / 3 / Lead Certificate #:
If the project Is exempt from lead certification, please explain why: (see Page 3 for additional information)
��aLoS- Pos'T' 15.77
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BJLDING
In the last 12 months, has the City of Eagan Issued a permit for a similar plan based on a master plan?
Yes __Vo If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor;
Sewer & Water Contractor;
NOTE; Rem owl
the Informittoie
Phone:
Phone:
Phone:
1
CALL BEFORE 'YOU DIG. Can Gopher State One Call at (651) 454.0002 far protection against • ..,.. it m
bthre you intend to dig to receive locates of underground utiles. w,aontteoneralLc� under utility damage. Cell 48 hours
hereby acknowledge that this informshon is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that 1 understand this is not a parmlt, but only an applioadon fora permit. and work ie not to start without a permit that: the work will be In
accoriance with the approved plan In the cage of work which requires a review ano approval of piens.
Exterior work authorized by a building permit rued In accordance with the Minnesota Stop Suildln�Code must be completed wlthln 150
days of permit Iasua
x i� 4"
Appilcanre Printed Name
0T/C0 39 d 1NI W 1X3 I3i3
Applicant's Signature
Page 1 of 3
L9Z9T98ZT9 90 :VT t'TOZ/TT/b0
;
Remarks
Addition Sri" ???ti-1an 2nd Loc 10 eik 1 Parcel #10 14991 100 Ol Owner?-'..-:??illEt' (I'.,( Street- -W.-?. Laurel COllTt State Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date I
STREETSURF. &(00 1982 600 76 120.15 5 604. 6 COOT348 -2
STFiEET RESTOR.
GRADING 171 1975 114.43 11.44 10 114.43 A009870 1 27 81
Gradin2 "5 9 1982 123.04 24.61 5 123.04 C00 48 10-21-81
SANSEW TRUNK At3 1968 47.91 1.60 30 47.9 A009870 1 27 81
SEWERLATERAL - 1968 52.47 2.62 20 52.47 A009870 1 27 81
WATERMAIN
* WATERLATERAL 1968 ZO
WATER AREA 1977 95,81 6.39 15 95.81 A009870 1 27 81
** X 1982 1431.44 286.29 5 1431.44 C00 48 10-21-81
STORMSEW TRK 1982 402.73 80.55 $ 402. 3 COO 3tiS ZO-21-81
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET ti64iT' 1009 1986 153.70 15.37 10
Road Unit 185.00 23792 3-18-81
WATER CONN. 335.00 23792 3-18-81
BUILDING PER.
SAC
PARK Z
CITY OF EAGAN. Remarks
Addition Briar .Hill Addition Znd Lot 9 Bik 1 Parcel #10 14991 090 01
owner 'In, Street 3?219 Laurel Court State Eagan, hffV 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. ((D 1982 600.76 120.15 5 480.61 A010803 12-15-81
STREET RESTOR.
GRADING 171 1975 114.43 11.44 10 114.43 A009870 1J27/81
Gradin 5?1 1982 123.04 24.61 5 98,44 A010803 12-15-81
SANSEW TRUNK 1968 47.91 1.60 30 47.91 A009870 1/27/81
* SEWERLATERAL - 5 1968 52.47 2.62 20 52.47 A009870 1 27 81
WATERMAIN
* WATER LATERAL 1968 ZO
WATER AREA 1977 95.81 6.39 15 95.81 A009870 1 27 81
** S W Lat Stm L 1982 1431.44 286.29 5 1145.16 A010803 12-15-81
STORMSEW TRK bs 1982 402.73 80.55 5 322.19 A010803 12-15-81
' STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET 13GFK' 1009 1986 153.70 15.37 10
Road Unit 18
WATER CONN.
HUI LDING PEFi.
SAC
PARK 250.00 20263
CITY OF EAGAN Remarks -
Addition g?i a-£ Hi I I Additi an 2nd Lot 1.2 Bik I Parcel #10 14991 120 01
OwnerL(Irf!'- ?E7i. `A;Street-387.:i; 101117"a1 Conrt Stace Eagan_, MN 55122
Improvement Date Amoun[ Annual Years Payment Receipt Date
STREETSURF. 06Qo 1982 600.76 120.15 S 600.76 C007245 9-14-81
STREET RESTOR.
GRADING n7l 1975 11 . 11.4 0 114.43 A009870 1 '
Grading r
,q
1982
123,
- - I
SANSEW TRUNK ? 1968 47.91 1.60 30 47.91 A009870
* SEWER LATERAL - 968 $2.47 2.62 20 $2.47
WATERMAIN
* WATER LATERAL 1968 ZO
WATER AREA 1977 95.81 6.39 15 95.81 A009
** S/W Lat Stm L 1982 1431.44 286.29 5 1431.44 C007246 -14-81
STORMSEW TRK ?- 482 402.73 80.55 5 402.73 C007246 9-14-81
? STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET 4.i9",F- 1009 1986 153.70 /
Road Unit 185.00 23792 3-18-81
WATER CONN. 335.00 23792 3-18-81
BUILDING PER. 6532
SAC
PARK Z$Q.Qo 2026-1 914180
CITY OF EAGAN Remarks
AdditionRria7C'•Hill Additinn Znd Lot 11 Blk 1 Parcel #10 14997 176 b1
owner-Lqvj U. ` f? ? J'a'- sc,eet--,3823 Laurel Court State EaQan, hW 55122
. Improvement Date Amount Annual Years Payment Receipt Date .
STREETSURF. ?(yC 1982 600.76 120.15 5 600.76 C 0 247
--
STREET RESTOR.
GRADING 1975 114.43 11.44 10 114.43 A009870 1 27 81
Gradin 1982 1 . C007247
--
SANSEW TRUNK 1968 47.91 1.60 30 47.91 A009870 1/27/81
I* SEWERLATERAL - 1968 52.47 2.62 20 52.47 A009870 1 27 81
WATERMAIN
* WATERLATERAL ja7 1968 ZO
WATER AREA 1977 95.81 6.39 15 95.81 A009870 1/27 81
** S/,W Lat 5tm &}j 1982 1431.44 286.29 5 1431,4 C007247 9-1 -
STORMSEW TRK 1982 402.73 80.55 5 402.73 C00 7 9-14-81
SEW LAT
CURB & GUTTER
SIDEWALK
STREET4;1 1009 1986 153.70 15.37 l0
Road Unit 185.00 23792 3-18-81
' WATER CONN. 335.00 23792 3-18-81
BUILDING PEfi.
SAC
PAFK • 20263 8/4180
•- ' CITY OF EAGAN
3795 Pilot Knob Road Eagen, MN 55122 Nc- 6533
PHONE: 454-8100
BUILDING PERMIIT Receipt .#
To be aeed For Est. Value Date , 19
Site Addreu Erect ? Occuponcy
Lot Block Sec/Sub. Alter ? Zoning
Parcel #
W Name
; Address
b
Ci Phone
?o Name
?
?? Address
Ci Phone
?
UNome
_? Address
1 hereby acknowledge thot I have read this opplication and state that
the information is correct and agree to mmply with nll applicable
Stote of Minnesota Stotutes and City of Eagan Ordinonces.
Repair ? Fire Zone
Enlarge ? Type of Const.
Move ? #k Stories
Demolish p Front ft.
Grade ? Depth ft.
Aoororah Fees
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off.
APC
Permit
SurcFrorge
Plan check
SAC
Water Conn.
Water Meter
Road Unit
Total
Signature of Permittee I
A Building Permit is issued to: on the eupress condition that
all work shail be done in occordance with all opplicable State of Minnesoto Statutes and City of Eagan Ordinances.
Building Official
PermM # DaN Imed PwniMN
Plumbing
Mechanicul J_7' /,x -,Op/ ?
INSPECTIONS DATE INSP• Rough-In Finol
FOOtiflg5 Date Insp. Date nsp.
Foundation
F ' s. , Plumbing
Mechanicol
Final
Remarks:
??
7-.3? --or/
CITY OF EAGAN
• 3795 Pilof Knob Road
No. Eegan, Minnesota 55122
. Phona: 454.8100
_ PERMIT
Date:
Site /lddreu: '
Lot Block Sub/Sec.
Name
? Address j
?
Ciry Phone:
Name '
r
Address , ? .
?
City
Phone:
This Permit is issued on the express condition thot all work sholl be
Minnesoto Statutes ond City of Eo gon Ordinonces.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single I
Residential
Multi Res., Comm./Ind. I
New/Alter. / Repoir
Cost of Installotion
Permit Fee
Surcharge '
Tota I
done in accordance with ull applimble State of
Recaipt MECHANICAL PERMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Print legibly
1. Date 2. Installation Cost
3. Job Address Lot Blk.
Trect "7.gTh1 2
4. Owner cllefson F?ldr^.
5. Contractor Vredri c;;son I[eat7 i'?' Phone
6. Address '??(1 RaaL nI R,i ;ri,
7. City Earan State
2ip
I 8. Building Type: Residential In Commercial ? Institutional O
I 9. Work Description: New CY Add ? Aiter 0 Repair ?
10. Describe Fuel Type
1 11
No. ment BTU - M. Ea.
Forced Air No. Eauipment CFM
Mfg. _ qir Handling:
Boilers
Mfg. - Mech. Exhaust
Unit Heater
Mfg.
_
Air Cond. Other
Mfg,
Gas, Piping Outiets
I 12. I hereby certify that the above information is true and correct, and I agree to
, comply with all ordinances and codes governing this type of work.
. Signed: for
Rough F Inal
• Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
Parmit No.
Fee
S/C
Tot.
C?rrttftratt uf Orrupanry
Citp of (Eagan
Erptt-inpn2 of BuiCbircg Jn,spertim
Tbis Ccrtificate irsued pursuant to the requiremenu of Section 306 of the Unifornz Building
Codc urti fying that at tbe time of itcuanu this rtrutturt war in tompliance wrth tbe various
ordinancca o f tbe City rrgulating building connruction or ust. For the f ollouzng:
1 of Q PLEX 6533
U, Chaifiutim n 'r Bidg. Pemtil No.
??Pa?YTyPe =L3 PComtmction Y PirtZon ? ZoninBD"utric
?m ?M?6 qelleeon B1dT8. Aaa? 1316 Holyoke ?A., Apple
BuldingAdd? 3825 LeuPel Ct. LoW.tY Lot 11.B1oCk 1,BriaT211ll
T-}`R,`?- n.m: JulY 301, 1981
rM7 IM .? COnS??CVOVS ?LI.CF
000[5 1.
Receipt??' PLUMBINGPERMIT PermitNo.(??
• CITY OF EAGAN
Fee
-' l Fill in numbered speces S/C
Type or Print legibly Tot.
.-
1. Date .
F J
2. Installation Cost ?
?
'?o`7? i7 Blk
T
L
3. Job Addrece
- .
ract
o
?-
`' -
4, Owner
1,F:")? :.2
US?fr-
5. Contracto r?,?j? Phone
r
6. Address ?Ci?? ,L''??j ? f /r ?`
7. City_--?r? State -7
8. Building Type: Residential-?0 Commercial ? Institutional ?
9. Work Description: New 0 Add ? Alter ? Repair ?
10. Describe
11,
No, Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
_ Lavatory ? -' Softner
Shower Wel I
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
Rough
Inspections: Date Insp.
for
F inel
Date Insp.
This is your permit when numbered and approved.
Approved CITY OP EAGAN 454-8100
' . CITY OF EAGAN
• • • 3795 Pilot Knob Roed Eapan, MN 55122 N? 6 5 3 2
PHONE: 454-8100
BUILDING PERMIT Receipt #
Te bs wsd for Est. Value Dote , 19
Site Address ?- ??• Erect ? Occupancy
Lot Block $ec/Sub, Alter ? Zoning
Parcel # Repoir ? Fire Zone
Enlorge ? Type of Const.
W Nome
_.. .
Move ? # Stories
I
., ?. .
; Address Demolish ?
Pront -- - ft.
o Ci Phone Grade ? Depth ft.
? ApProvals Feea
Z0
U?V
?
Name _
Address
Name _
Address
I hereby acknowledge that I have read this application and state that
the information is correct and agree ta comply with all opplicable
State of Minnesota Statutes ond City of Eugan Ordinances.
Permit '
Surcharge
Plan check
SAC
WaterConn.
Water Meter
Road Unit
Total
Signoture of Permittee I
i - - ,
A Building Permit is issued to: on the express condition that
all work sholl be done in accordonce with all applicoble State of Minnesoto Statutes and City of Eagun Ordinances.
Building Official
Assessment -
Woter & Sew.
Police
Fire
Eng.
Planner _
Council _
Bldg. Off. _
APC
PMnk # DeM Iwsed PwsltMa
Plumbing a_3 / o 3- a g - ?(,
Mechonicol ?,
?
INSPECTIONS DATE INSP.
Rough-In
Finol
Footings Date Inso. Date Insp.
Foundation 4__9 4 y Plumbing
Frame/ins. _ Mechanicol ?
Final ?! sr
Remorks:
r?
No. •
arr oF Er?G,e,N
3795 Pilot Knob Roed
Eagan, Minnesota 55122
Phone: 454-8100
PERMIT
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Date: Receipt No.:
_ Single
" "r- • .
Site Address: Residential
-``°-
Lot Block ` Sub/Sec. =Y.j.ar dll Multi Res., Comm./Ind.
Nome
/Alt
r
/ Re
ai r
N
.
ew
e
p
Address i
f In
ll
C
t
t
ti
? os
o
s
a
a
on
City t`? T'T'jPhone: Permit Fee
Name Surcharge
.
Address
e
0
City
' Phone:
Total
This Permit is issued on the express condition that oll work sholl be done in otcordante with oll applicable Stote of
Minnesota Statutes and City of Eagon Ordinances.
Building Official
. ;
No. ' f99
Date: t
cirY oF E,?c,AN
3795 Pilot Knob Read
Eayen, Mieneseta 55122 INSPECTOR NOTIFICATION
Phone: 454•8100 R EQU I R ED BY LAW
PERMIT
3RTI Taimc+l ('t
FOR ALL INSPECTIONS
Receipt No.:
Single
Site Address: ? Residential "
,i.li i^.l I
Lot Block Sub/Sx. Multi Res.
Comm./Ind
,
.
"bllefson
Ncme
New/Alter. / Repoi r
A
; ddress Cost of Installation
City Phone: P
i
F
erm
t
ee
Name S
h
` urt
arge
g -
Address
?
City Phone: T
t
l
o
a
This Permit is issued on rhe express condition thot all work sholl be done in accordonce with all opplicable Stote of
Minnesoto Stotutes and City of Eagan Ordinances.
Building Official
QTnttfiratP nf (Orrupttnry
Citp of eagan
lBPpFIl fritPltf IIf BUtlbtlt3 3nsprrtiun
Tbit Catificate irsued Purruant to tbe requirement.c of Section 306 of the Uniform Building
Code certi f ying that at the time o f itsuarue this structure wur in compliance with the variour
ordinance.r of the City regulating building conttruction or use. For the f ollowing:
U,?chalfimeou i nf t,Pl.ex Bldg.Perndt .,a. 6532
Occupency Type 3Type CoosWCtion?V Fire Zone 3- Zoning Dirtrict R3
owwoeBuua;n8 Tollefson BLlders naary.13816 Rolvoke La., Apple
Nu: June 30s 1981
'06T IN A CDNSI??CUOVS ?LAC[
mGOES nB?
.
(Etrtiftrtttt vf (Orrupttnry
Citp of eagan
IOrpartmrnt rrf Nuilbing 3niiperfimt
Tbit Ctrtifitatc iuued pursuant to tbc Tequiremtnu of Section 306 of tbe Uniform Building
Code certifying thaa at thc time of istHance this rtructure wa.c in cornpliance with tbe variox.r
ordinancet o f the City rcgulaang building construction or use. For the f odloxuing:
uxC,am„"tim 1 of 4 PLEX Bfide.Peraut No. 6531
OcaupancyType fi3 TypeCoesinxtion V FircZn > 2oningDistrictR3
o.,ar of euDd;ne ^t:{ldersn,d.13816 HolYOke Ls., Apple
op Da1e:_Au6 ]fi . 14, 1981
-.?.?.?.
KNIT IN A CONf1ICVOV9 ?V.CE
.8,
,' _ • • CITY OF EAGAN
, 3795 Pilot Knob Raad Eagon, MN 55722
• PHONE: 454-8100
BUILDING PERMIT
To be asad for Est. Value
Site Address
Lot Block Sec/Sub. ' -
Parcel #
()llef:x?.
W Name _
z 7i{;1?
; Address "
? .... I 7a 11
w Name _
0
?? Addreu
? rt«.,
Name _
Address
N4 6531
::r -"'/' 1
Ered p Occuponcy
Alter ? Zoning
Repoir ? Fire Zone
Enlcrge ? Type of Const.
Move ? # Stories
Demolish ? Front ft.
Grade ? Depth fr.
Approvols Fees
Water & Sew.
Polite
Fire
Eng.
Planner _
Council _
Permit
Surcharge
Plon check
SAC
Water Conn.
Water Meter
Road Unit
I hereby acknowledge that I have read this application and stnte that Bldg. Off.
the information is corcect ond agree to comply with all opplicable AP? Total `
Stote of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittea
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applimble State ot Minnesota Stotutes and City of Eagan Ordinances.
Building Official
Receipt #
Ponslt # DaM lawd PmakNe
Plumbing
Mechanicol 232 ,? 3-2 y/ ? ?:?--?" ?
c.-K. C.-' /
INSPECTIONS DATE INSP.
Rough-In
finol
Footings Date Insp. Date Insp.
Foundotion 4-7- gy _ Plumbing
r ins. - Mechanical ?
mal I
Remarks:
No. IC)9
CITY CF EAGAN
3795 Wlot Knob Read
Eagan, Minnesofa 55122
Phone: 454•8100
PERMIT
Date:
Site Address: `
Lot Block Sub/Sec.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single I
Residentio{
Multi Res., Comm./Ind.
Nnme '-f?OZt New/Alter./Repair. ; Address Cost of Installation
O
City
• _?-' ? ` Phone: Permit fee
` Nome ?C`' Surctwrge
?
g Address ?- - , - .
e
0
V
City Phone: Totol
This Permir is issued on the express condition that all work sholl be done in accordance with all applicable State of
Minnesota Stotutes and City ot Eagan Ordinances.
Building Official
No.
CITY OF EAGAN
3795 Pilot Knob Road
Eegan, Minnesofa 55122
Phone: 454-8100
PERMIT
Date:
Site Address;
2rSl
Lot BI«k Sub/Sec.
i . -3.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single I
Residentiol
Multi Res., Comm./Ind. I ?
Name New/Alter./Repair. ` T-
; Address Cost of Instollation
O
CitY Phone: Permit fee
Name ??'Y'"'Y.i.?., :;?;!•. 'i`'f'?t:i:?
p? Surcharge
? •'. t° ? , .
} Address
e
?
City Phone: Totol
This Permit is issued on the express condition that all work shall be done in accordance with all applicoble State of
Minnesoto Statutes ond City of Eagon Ordinonces.
Building Official
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
uecervEO '
FROM
AMOUNT $ I
& DOLLARS
1 00
El CASH F-I CHECK
FOR
FUND COOE AMOl1NT
Thank You
BY
/
V
White-PaYers Copy
Yellow-Posting Copy
_ Pink-File CoPY
BUILDING PERMIT
Te Ir umeA in.
Site Address
Lot Block
Parcel .# -
W I Nome
3 Addre
0
p Name
??
u Address
CITY OF EAGAN
3795 Pilot Knob Roud Eagan, MN 55124
PHONE: 454-8100
Receipt .#
N° 6530
io
Erect ? Occupancy
Alter ? Zoning
Repair ? Fire Zone _
Enicrge ? Type of Canst.
Move ? # Stories
Demolish ? Front ft.
Grade ? Depth ft.
Approrols Feea
Est. Value
Permit
Water & Sew. Surcharge
Phone Polite Plart check
Nome
Fire
SAC
J Address Eng. Water Conn.
, Ci Planner WaterMeter
< Phone
Council Road Unit
I hereby acknawledge that I hove read this appiication and stote that Bldg. Off.
the informotion is torrect and agree to mmply with all applioable
State of Minnesota Statutes ond City of Ecgan Ordinances. APC Total
Signature of Permittee
A Building Permit is issued to: on the express condition that
oll work shall be done in accordance with ell opplicable State of Minriesota Statutes ond CiTy of Eagnn Ordinances.
Building Official
Pxmit # DaH Ipued PaneMhe
Plumbing n
Mechanical 9 7 ? - ? - y
:-i_? r :i 5"4 / 5? y` - ?Z - y/ ?... -h-.?i?i??
INSPECTIONS TE INSP.
Rough-In Final
Footings Da Insp. -Date Insp.
Foundation Plumbing ?
t
.?
-
e ins. Mechanical / .
.
al O_ ^
Remorks:
/
No. `
Dute:
Site Address:
CITY OF EAGAN
3795 Pilet Knob Roed
Eegen, Minnesota 55122
rhone: 454-8100
PERMIT
Lot Block ` Sub/Sec. ?iar?iill 2n`1
,,,
Nome Tb -9d1 c?1(."' .
; Address 1?,3).C "z.?]„( ;,' ?fi
O
,oV
City )` - Phone:
?
Nome
.
? Address
rry
20.50
This Permit is issued on the express condition that all work shall be done in accordance with all applicable Stote of
Minnesota Statutes and City of Eogan Ordinances.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single I
Residential
Multi Res., Comm./Ind.
New/ Alter./ Repair
Cost of Instcllation
Permit Fee
20.00
Surchorge
Toeal
Building Official
No.
Date:
CITY OF EAGAN
3795 Pilof Kneb Roed
Ea9an, MinnesoM 55122
Phone: 454-8100
PERMIT
SiM Address: :! 1 ° "'LL7"P.1 C,`E
Lot ' Block ? Sub/Sea
i Name `rollefsOA1 L-'1C11'8.
? Address
?
City phone:
Nome - . _ •-- .
g.
y
? Address
City ' Phone:
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single I
Residentiol
Multi Res., Comm./Ind. I
New/Alter. / Repair
Cost of Instollction
Permit Fee
Surcharge
Totol
This Permit is issued on the express condition that all work sholl be done in accordance with all applicable $tate of
Minnewta Statutes ond City of Eogon Ordinonces.
-Jn. c:r
20.1
euiid„g officiai
CITY pF EAGAN SEWER SERVICE PERMIT
3745 Pllot Knob Rood PERMIT NO.:
Ea9an, MN 55122 DATE:
Zoning:
No. of Units:
Owner:
Addresr. -
$ite Address:
Plumber:
I °sre° t° eomPlY M'ith fhe Ciry of Eagon Connection Charge:
O?dinaneea. Acmunt De
posit: _
Permit Fee:
Surcharge:
B
Y Misa Charges: _
Dote of Insp.:
Total:
Insp.: Date Paid:
CIYY OF EAGAN WATER SERVICE PERMIT
3753 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner: _
Address:
Site Address:
Plumber.
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
1 agrea to eomply with the City of Eagan $urcharge:
Ordinanus. Misc. Ciwrges:
Total:
BY Date Paid:
Date of Insp.: Insp.:
Insp.:
OF EAGAN
PiSot Knob Road
MN 55122
Address:
IauTel CC
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
_ No. of Units: -
No.:
agree Po eomply with !he Cily of Eagan
Connection Charge: ?
Account Deposit: ?
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Date Paid:
WATER SERVICE PERMIT
ciTY oF enGAN
3795 Pilot Knob Rood PERMIT NO.:
Eagan, MN 35122 • DATE:
Zoning: No. of Units:
Owner: - -
}tddress:
Site Address: ?
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit: '
Reader No.: Permit Fee:
1 agree to wmply with the City of Eagan • Surcharge:
Ordinnnees. Misc. CFarges:
By
Date of Insp.:
Total:
Date Paid: -
I nsp.:
C:T Y OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Rood . . PERMIT NO.:
Eagan, MN 55122 DATE:
Zanin9: No. of Units:
Owner:
Address:
Site Address:
Plumber.
I agree to eomply wifh the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
BY Misa Charges:
Date of Insp.: Total:
Insp.: Date Paid:
CITY OF EAGAN SEWER SERVICE
3795 Pilot Knob Road PERMIT NO.:
Ecgan, MN 55122 DATE:
Z.,nina: No. of Units:
Owner: -
Address: -
Site Address:
Eui?
Plumber:
1 agree to comply with tha Citr of Eagan
Ordinances.
By
Date of Insp.:
Connedion Charge:
Account Deposit: _
Permit Fee: -
Surcharge:
Misc. Charges: -
Total:
Date Paid:
PERMIT
3
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pi.ot Knob Road PERMIT NO.: ?
,an, MN $5122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
I egree to wmply with tha City of Eagan Connection Charge:
Ordinanees. Account Deposit:
By
Date of Insp.:
Insp.
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Date Poid:
WATER SERVICE PERMIT
CITY OF EAGAN
:
PERMIT NO
3795 Ptlor Knob Rood .
in, MN 55122
; DATE:
, of Units:
No
Zoning: .
'
Jwner. -
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
osit:
nt De
A
Size: p
ccou
it Fee:
P
Reader No.: erm
r
e:
h
S
1 ugree to eomply witl+ fhe Cify of Eagan g
o
urc
es:
Char
Mi
Ordinances. g
sc.
T
t
l
o
a
:
id:
P
D
t
BY a
a
e
Dote of Ins
: I ^SP•:
p.
. minnesoca state noara ot tiectncity
Griggs Midway Bldg. - Room N191
, 1821 University Ave., St. Paul, Minn. 55104 - Pkone 297-2111
-REQUESLFOR ELECTRICAL INSPECTION
CH'ECK BELOW WORIC COVERED BY THIS REOUEST
? EH-00001-02
' 4415
T 2?612
Type of Building New Add. Rep. Check Applian ces Wired Foi Check Equipment Wired For
Home 30 ? ? Range • Tempocary Wiring ?
Duplex ? ? ? Water Heater ? Lighting Fixtuces ?
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commercial Bldg. ? ? ? Furnace EY2 • 00 Silo Unloader ?
[ndustrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ?
Farm ? ? ? List List
Other ? ? ? o
HereIS( DisA.Dls. .xx4. p
Heterg?
COMPUTE INSPECTION FEE BELOW
Secvice Entranre Size: # Fee 1 1 Feeders&SubPeede[s: # Fee Ciicuits: # Fee
9toI00Amps.1( XUU .5 0 to 30 Am res 0 to 30 Am eres .
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres
Above 200 Amps. Above 100 Amps. Above lOQ_Amps.
Transfo ' „
. Remote Control Cira Partial or other fee
Signs ; ? Special Inspection Minimum fee S
Remazks
Jeff D.? ? TOTALF ?•?
34600
1, the Electrical Inspector, hereby certif it?a'aKthe
Y
(Rough-in) (/cJ.
(Final)
has bee made.
bate
Date /e
This request void
18 months from
This request void e?
18 months frrm
17ate of this Request 3-30-1981 Fire No. T 25612
?,r[, as Micensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. 3825 La.urel Court City Ea.gan
Section Township Range County Dakota
Which is occupied by Tollefson
(Name of Occupant)
Is a roughin inspection required on this job? No ? Yes EY Ready Now O Will Call EF
Power Supplier Dakota Gty. Address Farmineton
O.B. Thompson Electric Co.
Electrical Contractor
Aq06o2
Contractor's License No.
dCompan Name)
Mailing Address 12201 tka B?vd. , Mtka 55343 11, . (Electrical Contractor oLOwner MakMg This Installation) ' .
Authorized Signature PhoneNo.
(Electrical Contractoror Owner Making This Installatlon)
This inspection request will not be accepted hy the :
l1Li ?il' 5tate Bdard unless proper inspection fee is enclosed.
. nmeaVaw uwao Walu or n?anciry
Griggs Midway Bldg. - Room N191
? 192'f'University Ave., St. Paul, Minn. 55104 - phone 297-2971 ?
REQUEST FOR ELECTRICAL INSPECTION ? CHECif BELt)V WOAK COVEREB BY TH1S RF.CIiiF.ST
? EB-00001-02
?
T 25613
Type of Budding New Add..Rep. . Check Appliances Wired For Check Equipment Wiied For
Iiome 3d3dg ? ? Range fk4.00 Temporary Witing ?
liuplex ? ? ? Water Heater ? Lighting Fixtures 19
Apt. Bldg. ? ? ? Dryei ? Elec[iic Heating ?
Commercial Bldg. ? ? ? Fumace gEkQ, OD Silo Unloader ?
Industrial Bldg. ? ? ? Ait Conditionec ? Bulk MIlk Tank ?
Farm ? ? ? List List
Other ? ? ? p
Herers? Disp.Dt sh*XX4, Heiels?
)
COMPUTE INSPECTION FEE BELOW
Setvice Entrance Size: # Fee 1 1 Feeders&Subfeeders: # Fee Cirwits: # Fee
0 to 100 Am s. , 0 to 30 Am eres 0 to 30 Am eres +
101 to 200 Amps. 31 to 100 Ampe:es 31 to 100 Am e:es
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Transfoimer mote Control Circ. Paztial or othei fee
50
Signs p cial Ins ection Minimum fee .
Remarks ? Jeff D. TOTALF aj:?.50 4+00
1, the Electrical Inspector, hereby certif t the o irrSpection has been ma3?,
(Rough-in) Date ir/?
l
(F??) Date Ya ?-
This request void '
18 months from
122?-??Cz.?-'t?.?/
This request void .4 f d, ?1//
1E months from "? S ??? ?
Date of this Request Fire No. T25613
I, asxM Licensed Electricat Contractor 0 Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. 3823 Laurel Court City Fae.an
Section Township
Range County
Dakota
Which is occupied by Tollefson
(Name of Occupant)
Is a roughin inspection required on this job? No ? Yes EF Ready Now ? Will CalM
Power Supplier nakn+ Cty. Address Farmington
Electrical Contractor O.B. Tho*apson Electric Co. Contractor's License No?0602
(Company Name)
Mailing Address 12201
Blvd. i, AAtka 55343
(Electrical Contractor or Owner Making-This Installation)
Authorized Signature '. Phone,No. .. L;'; is'?
(ElectrfcabCOntractor or Owner MSking This Installation)
Cff)ly This inspection request will not 6e accepted by the ..
j? ?; ? State Board unless proper inspectian fee i; enclosed.
mmnesoia acaia uoara or tiectnaty -Griggs Midway Bld'g. - Room N791 / EB-00001-02
- ,!1821 University Ave., St. Paul, M+nn. 55104 - Phone 297-2111 D i`J
'RE(2UEST FOR ELECTRICAL INSPECTION ? : ? ? ?,? ?
CHECK BEi,O?P'4COI2K COVEREB RY THiS RF.(lI1F.ST
'&ype of Building New Add. Rep. Check Appliances Wired For Check Equipment Wiced For
Home IOC ? ? Range -U . Temporary Wiring ?
Duplex ? ? ? Water Heater ? Lighting Fiutures _-a
Apt. Bldg. ? ? ? Dryer ? Elec[cic Heating ?
Commercial Bldg. ? ? ? Fumace =M. 00 Silo Unloader ?
Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ?
Fazm ? ? ? List ?n,
,,_ ,
nn List
Othex ? 0 ? __
ptheis ??.,,..1,?
Here -
? -- ,,
„ ,,, .
? Othecs?
Here f
COMPUTE INSPECTION FEE BELOW
Service Entcance Size: # Fce Feeders& Subfeedecs: # Fee Circuits: # Fee
0 to 100 Am s10 L'G ,90 0 to 30 Am eres 0 to 30 Am eres 8 1,00
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres
Above 200 mps. ? Above 100 Amps. Abwe 100 Amps.
Transform ` Z . emote Control Circ. Partial or other fee
Signs -+ pecial Inspection Minimum fee $5.0
Remarks Jeff D.?
,-, TOTALF 4.00
t, tne tlectncal lnspector, hereby certifhe Inerv pectio as been m?
(Rough-in) ate ?-? r3'l
(Final) - „ _ ? -_ ^? Date ?Gf r
This request void
18 months from
This request void :?
1 &:tionths from
Dite of thfi Request 3-30-1981 Fire No. 725614
I, as -B Licensed Electrical Contractor OOwner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. ?;891 T aural Covr City Ea.o-axi
Sectlon Township
Range County XXXXKDa_kota
Which is occupied by_ mnl l af4n.,
(Name of Occupant)
Is a roughin inspection required on this jo6? No ? Yesia Ready Now ? Will Call Q=
Power Supplier_ DaY.ota Ctv. Address Farmington
ElectricalCortractor O.B. Thomipson Electric Co. Contractor'sLicenseNo.A40602
(Company Name) -
Mailing Address 12201 I14t'.?a Bl-ad„, Nitka 55343.,
?(ElectNcal Contractor or,Qwner Making?Thls Installation) ' . .
Authorized Signature ?Phone No.
(Electrlcal Contractor or Owner Making This Installation)
? ?j This inspection request will not be accepted by the
??A?j }? ? RO?",=?RD CO[?'Y State Board unless proper inspection fee is enclosed.
mmnesoca scace Lsoara oi tiectncity
? Griggs Midway Bldg. - Room N191
7827 University Ave., St. Paul, Minn. 55104 - Phone 297•Z111
REQUEST FOR ELECTRICAL INSPECTION
INEC,.'C_BEZOW WORK COVFRFn RY THIS R17.0I1FST
EB-00001.02
7
25615
Type of Budding New Add. Rep. ('heck Appliances Wired For Check EquipmeM Wited For
Home V ? ? Range 0 - Temporary Wiring ?
Duplex ? ? ? Water Heater ? Lighting Fixtures 30
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commercial Bldg. ? ? ? Furnace :22.00 Silo Unloader ?
Industrial Bldg. ? ? ? A'v Conditioner ? Bulk Milk Tank ?
Farm ? ? ? List List
Other
?
?
? 1 Others? iU .
1 Here i.,.. . Qthers?
r?ere
COMPUTE INSPECTION FEE BELOW
Service Enttance Size: # Fee Feeders& Subfeeders: # Fee Circuits: # Fee
0 to 100 Am 40 UG . 0 0 to 30 Am eres 0 to 30 Am eres 8 ( 0
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres
Above 200 Amps. Above 100 Amps. Above LOD Amps.
Transformers Remote Control Circ. Partial or other fee
Signs Special [ns ection Minimum fee $5.
Remazks `?, Q - ?( ?? Jeff D.
(:.? T? _ i T07ALFEE ?,
y'g7
34.00
l,the
(Final)
This request void
18 months from
t?? certif?sCthe
c?.
has been ma?
'Date ?' ?? r
Date y
>
• 7 3 ev
TI9is request void L/G dli 33.S0
?'
18 months from
Date of this Request_3-30-1981 Fire No. ? 25615
I, as)U Licensed Electrical Contractor 0 Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. 3819 Laurel Court City j?gt?a-'i
Section Township
Range County Dakota
Which is occupied by Tollefso n
(Name of Occupant)
Is a roughin inspection required on this job? No ? YeM Ready Now ? Will Callt3
Power Supplier Dakota Ct,?v Addtess Farmir2gton
Electrical Contractor O.B. Thornpson Electric Co. Contractor's License NA40602
(COmpany Name)
MailingAddress 12201 Mtka Blvd.$ P,Itka 55343
_
(Electriwl Contfactor or'Owner Mskin9This Installation)
Authorized Signature
^ ? ? _- 'Phone,No. -
(Electrlcal Contractor or Ownel Making This Installatlon)
This inspection reqaest wiil not 6e accepted try the :. ?-
1?'E? State Board unless proper inspection fee is enclosed: '
. ., r
(gtrfifirtttr of (Orrixpttnry -.;-
, . Citp of (Eagan . .. ?- ?,. --
. ;
39Ppttr#menf nf luil,ding Jtwppriimt _-
. . - ?.
Tbit f.crti ficate is.cucd pursuant to tbe nquisemcnir of Section 306 of tbc Uniform Building
Codc certi fying tbat at tlx time of itsuancc this ttructurc iuat rn iompliana witb the variaur
wdiuarucr o f tbe City rcgulating bxilding connsuction or uie. For thc foUoudng: _
? .
,
•` ,; ,,;?„'? • 7k`` . r `? R :
Ur Chml"radm 1 o f' 4 PLEX 6530
B1dg Rmdt No.
O-PUKY Type R3 m,Cm,t?don v F,ML_. •"3 ,Z?Mtnc, R3
?m of 8UUm,` Tollefson Bidrs. Addnm 13816 Holyoke Ia., Apple V,
%.,a,_.:,,_ 3819 Iaurel Ct. .--,:_.I,ot lO.Bloek 1.Briarhill 2?
By.
October
H,,;,,;,,?a,?,, 1, 1981
-
- . :? - _ . . ..? - . - ' . .. , . . . . . ..i -..:,?;?_..
. ll}NOIM U.S.M.
CITY OF EAGAN N° 6532
. 3795 Pilot Knob Rond Eagan, MN 55122
PHONE: 454-8100
BUILDING' PERMIT APPLICATION Receipt # 937yw?
To be used tor 1 of 4 plex Est. Value 52r000 Date 3-19 , 1981_
Site Address3823 Tanral Ct _ _ Erect ? Occupancy -
Lot 12 _ Block 1 $ec/Sub. BT1dYY1111 ZriCI Alter ? Zoning
Parcel $k
z I Name `ibl 1 efSOn Bl drs ,
; Address 13816 'HOZy0IC2 I,YI
b
? Name _
0
?? Address
Name
Phone
Repair ? Fire Zone _
Enlarge p Type of Const.
Move ? # Stories
Demolish ? front ft.
Gmde ? Depth ft.
Approvals Fees
AssessrrpillIt ,
Woter & Sew
Police -
Fire
Permit 143 _ 50
Surcharge 26 _ 0
Plan check 71.75
SAC 525-?0
Woter Conn. -30AID
Water Meter --01_Qo
Road Unit 165.0?
?? I Address Eng. -
a'Z" City Phone Planner _
Council _
I hereby acknowledge thot I have read this application and stote that gldg. Off.
the informotion is corred and cgree to comply with all applicable APC -
State of Minnesota Statutes ond City of Eagan Ordinances.
Signoture of Pertnittee
A Building Permit is issued to: _
all work shall be done in accordance
Tollefscn Bldrs.
al I
of
Total I.F316.25
on the axpress condition thot
$tatutes and City of Eagan Ordirwnces.
Building Officiul
A
BUILDING PERMIT APPLICATION
N4 6533
Receipt .j? 23??;---
To be dsed for 1 of 4 plex Esr. Value 52,000 Dore 3-19 , 198?
Site Address 3825 Ix'iLl'CA1 Ct. Erect Na Occuponcy R3
Lot 11 Block 1 Sec/Sub. Br1dY'h7'll 2rid Alter ? Zoning R3
Repoir ? Fire Zone 3
Porcel #
Enlorge ? Type of Const. V
z Nome Tollefson Bldrs. Move ? # Stories
3 Address 13816 Holyoke Ln. Demolish ? Front 44 ft.
? ci A pp12 Vdl1.23phone Grade ? Depth 24 ft.
w
o Name
- ADProvals
- Fees
???
Address
~ Ciri Phone
Name _
Address
CITY OF EAGAN
3795 Pi1M Knob Road Eagan, MN 55722
PHONE: 454-8100
I hereby acknowledge that I have read this opplicotion and state that
the information is correct and agree to comply with all applicable
$tate of Minnesota Statutes and City of Eagan Ordinances.
AssessAOntl-2-2-80
Warer & Sew.
Police
Fire
Eng. _
Planner _
Council _
Bldg. Off.
APC -
Permit 143.50
Surcharge 26.00
Plan check 71 _ 79.
SAC 525_00
Water Conn. 305.00
Water Meter 60 _ 00
Road Unit 1 $5 _ 00
Total 1 ;'116_>2?
Si9nature of Permittee 1
A Building Permit is issued to: 'P0112fSOd1 BIdY'S. on the express condition thct
all work shall be done in accordanceAith oll appliq#e $loe of Minnesota Statutes ond City of Eagon Ordinontes.
Building Official
, _ 33 ? _ ?(n7 CITY CF FACAN Inclucie 2 sets of plans,
1 site plan w/elevations 6
? BUIIDING PEAtHIT APPLIChTION 1 set of energy calculations.
Rb Be Used Fbr Valuation Date -//-%
?
Site Address JOP?7/ Cl.???
//?i ICE iJSE Ot1LY
Lot?/,- zBlock / Sec.%Sub(?!?L??? Erect Q.cupancy
?
Parce1 f/) /OR/ //D /? / lter Zonin4
Fepair Fire Zone 3
Owrtier: Enlarqe Zype of Consr_, v
AddreSB: Move # St.ories _
DeRnlish Front y u ft.
City/ZiP aodec Grade ? DePth jL/ ft.
Ptlone #:
Addness: /J,
City/Zip Cbde:
Phone #: "
Arch. /tng. .
.
Address:
Cit]'/Zip Cocle: Pt?om 1{ :
AF'PRL7VAL.S FF?'S
ASSessfrnllts Pe[mit 1y3,S6
Water/Sewer Surcharqe o
Polioe Plan Chack 7 i.7s-
"FiYe SAfr .s 2s. e o
Eng. Water Conn. 3, S o a
Planrer Water Meter 4 a o 0
Cowticil Rcxad Unit
Hldg. Off.
APC
TarAL 1:3 • ? 'd-S'
x 4
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N° 6530
' PHONE: 454-8100
BUILDINCr PERMIT APPLICATION ReceiPt .#
To be uaed ior 1 of 4 plex Est. Volue 52 r000 Date _ 3-19 1981
Site Address 3819 LaUY'@1 Ct. _ Erect p Occuponcy R3
Lot 10 Block 1 Sec/Sub. I3rilThill 2rid Alter ? Zoning R3
Parcel # Repair ? Fire Zone _ 3
Enlarge ? Type of Const. U
w Name `'b11EfSOri B1dL'S. Move ? .{k Stories
; Address 13816 HOlyQke Lri. Demolish ? Front 44 ft.
° ci Apple Valley phone Gmde ? Depth 94 ' ft.
? Aoorovals Fees
Name
,o
ug Address
nw....,.
Nume _
Address
I hereby acknowledge that I have read this application end state that
the information is correct ond agree to comply with all applicable
State of Minnesota Statutes and City of Eogan Ordinonces.
AssessloGnt12-2-AO
Water & Sew.
Police
Fire
Eng.
Plcnner
Councii
Bidg. Off.
APC
Permit
Surcharge 26.nn
Plan check 71_75
SAC 525.00
Water Conn.305.00
Water Meter 60. 00
Road Unit 185) -nn
Total 1 F 316 _ 5
Signature ot Permittee I
A Buifding Permit is issued to; `I'0l12fSCR1 BZ(lY'S. on the express condition that
all work sholi be done in accordarxe with aII opaUcable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
BUILDING PERMIT APPLICATION
To be used For 1 of 4 plex E
52
Site Address 3821 LdLlY2l G`t.
Lot 9 Block ISec/$ub. 13riarhi11 2rid
Parcel #
w IN.n,, Tollefson Bldz'S.
; Address 13816 Holyoke Ln
---
p Nome _
?
?U Address
Name _
Address
Receipt #
N° 6531
0 Dote 3-18 - -, 19B1_
Erect bi Occupancy ?
Alter ? Zoning
Repair ? Fire Zone 3
Enlarge ? Type of Const. V
Move ? # Stories
44
Demolish ? Front - ft.
Grade ? Depth 24 ft.
Aoorovals Feee
AssesA(antl 7-7-R (1
Water & Sew.
Police
Fire
Eng.
Planner
Council
Permit 143.7V
SurcFwrge 26.00
Plan check 71.75
sAC 525.00
Water Conn.305. 00
Water Meter 60.00
Road Unit 185.00
I hereby ocknowledge that I have reod this applicotion and state that gldg. Off.
the information is correct ond agree to comply with oll applicable ??? ?
Stote of Minnesota Stotutes and City of Eogan Ordinances. APC Total f.-
Signoture of Permittee
A Building Permit is issued to: `1b1lefSOri BZCZY'S. on the express condition that
all work sholl be done in occordance ith all appli le S ote of Minnesota Statutes ond City of Eogan Ordinances.
Building Official A ?? ? ? '?'? ? "' ? -?"
CITY OF EAGAN
9795 Pllot Kno6 Road Eogon, MN 53122
PHONE: 454-8100
,
RESIDENTIALBUILDINGn
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtlon Reauirements , RemodeUReoair Reauirements
3 registered site surveys showing sq. ft M bt, sq. ft. of house; and all ?/;?; lan showing footings, beams, joisis
(20yo maximum lot coverege allowed) ?`? d ???? ?r heated addibons
2 copies of plan showing beam 8 window sizes; poured found desig 1 sile sun?y?f dditions & decks
t set of Energy CalculaGons SEP ,?1, d? on - in e if on-site septic sysfem
3 copies of Tree P2servaGon Plan 'rf lot platted after 711193 npI C(J?l
Rim Joist Detail Op6ons seledion sheet (buildings with 3 or less units) ?
Minnegasco mechanipl ventilation fortn
fl?5D.,Ds
06U
offceusern,mkD
Cert of Sur4ey Recd _ Y_ N
Tree Pres'Plan Recd • Y N
TreePres.Required _Y _N
On-siteSepticSystem, _Y _N
Date
Site Address 322 3 L. Au,Q,gL Construction Cost
C' 6 v27- UniUSte #
Description of Work J:EAIOV6- leEpLR-CC p«,? ?yp Zti6--S
Multi-Family Sldg X Y_ N Fireplace(s) _ 0_ 1 _ 2
PropertyOwnerY 145-- '-'f+nu„/ A,,YAh-cs,u1- %714,u4 C, r-,H,,.-
7622 L. 1,411E /?liAO /r7/,vtE Telephone#(74-, 3 ) 37 2 7
?T/LGVE /f>i(/ S53i?
Contractor BE1 E)CrF R I Q2 ?1A 41Ni C(}(ZP
Address 4os- Kgs- 6nn+
State ?IUMPS(}M 372eET
Zip Jr,J'rq? 1 City MINNC"OLIS
Telephone#(6I7 ) 261`67-q'3
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Categorv 1
(4 submission type) • Residentiai Ventilation Category 1 Worksheet
Submitted
• Energy Envelope Calculations Su6mitted
A NEW BUILDING
_ Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
In the last 12 monihs, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Applicant's Printed Name Applicant's Signature
Lv lI va TI1\111JY1'JLV rI aiiau u.l1i
{
Sub TVpes
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? OS 03-plex
? 06 04plex
Work TVpes
? 31 New
? 32 Addition
? 33 Alteration
`e 34 Replacement
? 13 16-plex
? 16 Fireplace
? 17 Garage
'0 18 Deck
? 19 Lower Level
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn. (4-sea.)
? 23 Porch (screen/gazebo)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement D 38 Demolish interior ? 44 Siding
? 36 Move Buiiding ? 42 Demolish Foundation 0_ 45 Fire Repair
? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
*Demolition (Entire Bldg) - Give PCA handout to applicant
DeSCriptiOn: Water Damage _ Yes
Valuation DDp, rvo
Plan Review 100% or 25%
Census Code Y 3?
SAC Units
# of Units
# of Bldgs
Type of Const
Occupancy 4- zc I MCES System
Zoning ?-? City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
REQUIRED INSPECTIONS
Footings (new bldg) _ Sheetrock
_6? Footings (deck) FinaUC.O.
_ Footings (addition) ? FinallNo C.O.
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tests Final
_ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
Insulation Retaining Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MC1ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 07 05-plex
? 08 06-plex
? 09 07-plex
? 10 08-plex
? 11 10-plex
? 12 12-plex
?
I`
Y4?'yi!, Lf}t,??'e? WJl?7
Tolllefson Buildara Inc. Or,11201 ? `"?..?• 183-10
so, F. C. JACKSON
1 ,'.;?'rh5i1
,•y .. LAND SURVEYOR
- ?T.' ? .? RFGIS7EPEG UNpHp LAWB OP BTATE OF kINNBBOTA
?.?y,'... UC6NSHD BY OROINANC[ OF CIT' G MINNEAPOLIB ?
• i ''- ;??'?§ 9618 EAST SSiN STREET 55417 727-3494
P7
? '` ? - ptbtpOC'? Q?fC1f{Udlt ?
VACANT
83.15
9. q
13.17 'r?ev 21.66 21.66 N.17 `O o? N ?
O ' n M• '? I
?
30
286.37' N p
N /2s7
? IO'OFFSET 44.00 44.00 30, 2°23 98'?
i ? ? /
? @0?
!1F /?7 N
13.17 a g? 3455
? 9.17 21.66 21.66 N a 13.17 1 I I 9.17 ?
10'OFFSET
p
Qf i g1?5 l?? 3?Zd
A,A I
11 J\ 9\I
1 '
i 060,0 = Exieting Elevatioae
p ' . , . . . . . . . . . ...
a ? ___ : Drainage and Utility Easementa
'
Drainage
j SCALE; I":30' Propoaed garage flvor Elev. 95,0
0 DENOTES IRON
? • DENOTES SPIKE and Bneemenk
GPGI- g16 Ptopoeed Firat Floor Elev, 103.85
1 `
I hereby certify that t ie Ls a true and correct plat of a aurve.y af:
Lota 4,10,11 and 12,Dloek l,Brier Hill 2od. Addition,Dakota County,Minneeota.
"Af BURVEYCD BY Nfi THiS 5th. DAy ? NOV, a p. 1980 S8? ffe x4 a..20'27'23 SIGNC
' i F. C. JACKSON. MiNN[eoT^'? ?oiaraA7aN. No. 3800
?. .
?
A
I?
i
I
„
,
?
?
?
A?v
J
?P
P
0
y?
?vP
.'
I
I
I
I
?
I
I
i
?
I
?
i
. I
I
I
I
I
?
i
i
I
I
I
I
I
I
I
i
I
I
I /
j,
?31icfaan 8uildera Ioc. Or,11101
183-70
F. C. JACKSON
uwu suaveroe
Ri618TERED VXOlR U1W8 O' 6TAT8 OI MINNMpTA.
LiciHaco sr onweuMa oP cin or wiNNurous ?
9818 EABT SSTN STREET 55417 727•3484 ?
urucpoc'g Certificate O
VACANT r `
lJ
r
? J
e3.15
I a 10' OFF$ET?
9.17 ? J
? 9A? I I a m 2166 16 N 17 p't N
1317
30
?l
286.37' N a /
N N ?
N .
N ? 129' I ? .
10' pFfyET 44.OD ?44.00 30,
? 9% ` R;g
N
.
7 ?
N N
13.17 Q 9g5
N 21.66
9.17 21.66 N a 13.17
1d OFFSEi 9.17 12
?
9N.5
94 ;
060.0; Exiating Elevatioae
Dninage aad Utilitq Eqeementa
Drainage
SCaLE: i":ao' Propoeed gsrage floor Elev. 95.0
0 DENOTES IRON
• OENOTES SPIKE and B?eenent
g16 Pr0p0sld F11sC FL00[ EIEV, 103,85
G
I hereby certify that t ir ie a true and correct plat of a eurvey of:
? Lota 9,10,11 and 12,Eloek 1,Brier Nill 2od. Addition,Dakoh County,Minneeota.
' 1As eumcreo w r¢ rHi¢ 5th. ?r OF Nov, D. 1980
;
? 20•27-23 sieNe ?
F. C. JACKSON. MiNN[eoi croiaAiroN, N0. SE00
!
¦
CITY USE ONLY 997
L? BL / RECEIPT#: rIO SUBD.421tiz? 'HY RECEIPT DATE: 7
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 661-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES EACH NO, TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot TublSpa 3.00 x =
Water Heater 3.00 x
Floor Drain 3.00 x =
Gas Piping Outlet • minimum -1 • 3.00 x =
Rough Openings 1.50 x =
Water Softener "fordwellings underwnstrudion 5.00 x =
Water Softener ' for existing dwelling 20.00 x =
U.G. Sprinkler ' for dwelling under const. 3.00 =
U.G. Sprinkler ' for existing dwelling 20.00 =
Alterations " to existing residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ` Dak Cty lic. 75.00 =
(new and returbished systems)
Private Disposal Systems'Abandonment 20.00 =
STATE SURCHARGE
TOTAL
.50
I hereby adcnowledge that I have read this appGcation, state that Me inTOrtnation is corred, and agree to compty wRh all appiicable City
of Eagan ordinances. R is the applicanYs responsibility to notiTy the property owner that the Ciiy oi Eagan assumes no liability for any
damages caused by the City during its nortnal operational and maiMenance activities to the facilkies constructed under this permit within
City propertylright-of-way/easement.
SITE ADDRESS:
,
OWNER NAME:
INSTALLER NAME: , HONE #: 96Lo "l?D 9oZ.
STREET ADDRESS: ?
3
CITY: STATE: MAI zI P: 5-5-412
SIGNATURE OF PERMITTEE
City of ?? __ '_- _--____- i
I Fo? Q.L„f?c? Use
I ?! t
? .Permit#:
i PermitFee: ? EzJi
? Date Received:
I
I Staff: L I
I I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: iw 3/,e Site Address: V? R IA 2 Oi L L-
Tenant: Suite #:
RESIDENT/OWNER Name:e/v A5soet .a-.o?J Ffp,3e-1 z- phone: 9 v-37.Z 7
Address / City / zip: 3 g X( L Mcj /L L L
Applicant is: _ Owner X Contractor
TYPE OF WORK Description of work: {Z £- f3 G.?
Construction Cost: 41)60, G? Multi-Family Building: (Yes X / No
CONTRACTOR Name: (? £/ E'X 7--c2l o!L *M 1,4 ;. License #: 3.?.2 41111 I
Address: t?L -f L.:'
City: /yJ P L SI
State: Zip: SS 4/1 ?j
Phone: L, 2V3 Contact Person: 4vQ'2i S
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer 8 Water Contractor. Phone:
NOTE: Plans,and supporfing tdocuments that you su6'mi# are, consideced to [ie public irtfornation: Portrons of
the information may be classified as'nan-public if you provide,specific,reasons.that would per,init the C?ty to
:conclude that the are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in confortnance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and wor 's not to sta out a permit; that the work will be in
accordance with the approved plan in the case of work wh? \J
i'cIhC?re/7 uire a review and approv of ans.
? I ?- E IJ ??III
X?el Ly ,i:e,/La2 r 5 ? x
ApplicanYs Printed Name L lf APR 0 3 2008 V ApplicanYs Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
? Foundation ? 05-plex ? 16-plex ? Accessory Building ? Pool
? Single Family ? 06-plex ? Fireplace ? Porch (3-season) ? Ext. Alt. - Multi
? 01 of _ Plex ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF
? 02-Plex ? 08-plex `e Deck ? Porch (screen/gazebo/pergola) ? Multi Misc.
? 03-Plex ? 10-plex ? Lower Level ? Stortn Damage
? 04-Plex ? 12-plex ? Miscellaneous
WORK TYPES
? New ? Interior Improvement ? Siding ? Demolish Building*
? Addition ? Move Building ? Reroof ? Demolish Interior
? Alteration ? Fire Repair ? Windows ? Demolish Foundation
? Replacement ? Egress Window ? Water Damage
' Demolition (entire building) - give PCA handout to applicant
DESCRIPTION:
Valuation 3? DOD •- Occupancy .71? C -? MCES System
Plan Review Code Edition Z'D a '7 SAC Units
(25%_ 100% Zoning ? City Water
Census Code y 3 Y Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Const. Width
REQUIRED INSPECTIONS
Footings (new bldg) Sheetrock
?p Footings (deck) Final/C.O.
_ Footings (addition) }+ FinaUNo C.O.
Foundation HVAC
Drain Tile Other.
_ Roof: _Ice & Water _Final Pool: _Footings _Air/Gas Tests _Final
Framing Siding: _Stucco Lath _Stone Lath _Brick
Fireplace: _R.I. _Air Test _Final Windows
_ Insulation ? , A Retaining Wall
Reviewed By: ?f(l?(/1? _ Building Inspector
------------------ -------------- ?
-- -----
RES(DENTIAL FEES:
Base Fee
Surcharge
Plan Review
MC/ES SAC
Gity SAC
Utility Connection Charge
S&W Permit & Surcharge
7reatment Plant
Copies ? Z 1 cs ?
Total
Page 2 of 3
. ?? , . . . ? 'Toi•Iefaan Bailders Inc. Or.11202
183-70
?
F. C. JACKSON
, uno suRVEroR
, NE615TEAE0 UHOEA LAWS OF BTATE OF MINNESO7A
UCENSEO BY OROINANCE OF C1TY OF MINNEAPOLIB ?
8616 EAST 58tH STREET 55411 727-3484 Q7
? - J
ur%'o Ccrnftet O
VACANT
`J
? ' -
83. ?5 -Ij
r ? 9.I7 ? ? 9 l??lo? `' J
?
% A5 13.11 a N 2L65 21.6 6 9.17 ,,,yyy 4M
?gY• Np. ? ? Q r
M
J
'---- i z86.37' N?? E?SIO?D? 1 ?? 30
ND
gUU???G, N 12S7 ?
4-4z2 ?
? ID' ? ' ET 44.04 44.00 30, °3'
P O
??'? I a F?J
/ N ' -.
13.17 y ? 55
21.66 -5A
?
.I
a a I7 ? ?,
I I z1.66 I3.
? , 917
12 ?.?. ,
? ?
10'OFFSET 98
OQp ? ? cn
o
I ?
e I o V OEQ? n 9,15
J ? -
? Dq?e Q?
? Su000,0_Existing Elevasiona
a ? 02
_?rainage aad Usility Epsementa
i
Draiaage
I
i ScaLE: 1"=30' Propoaed garage floor Elev. 95.0
I 0 DENOTES IRON pR
? • DENOTES SPINE and Baeement
I ?A??? Gp?pGE 9? 6 Propased Firat Ftoor Eiev. 103,85 I
I 3 E tipS?
e?
,
I heraby certify thac t is ta a true aad correcc ptat of a aurvey of:
Lote 9,14011 and 12,Blocfc 1,8rier 4i11 2ed. Addition,Dakota Councy,Minneeota.
?J
Af SURVEY6D 9Y qC TNt. 5th. OAY W xD9' D. 1980
V$O 20'2I'23 SIGNE / ?1-'
j
F. C. JAGKSON, MINN[soTk ? Gis7ruTrom. No. 3800
, .;:.`'. .
? _ _ _ _ _ _ _ _ -_ - _ _ _ _ - ?
? FO[ Q?G2'_1?38 ?
? Permit
I I
i Permit Fee: , ?C?) • ?.? i ,
? Date Received:
I ? I
I Staff: ?
I I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ?J 3 n D ' Site Address: A (Z L L -To L„-3 x1 Nv iK E S
Tenant: Suite #:
RESIDENT/OWNER Name: ?/C' PF10n8: 7?-T-y45/- 37;27
Address / City / Zip: L.o-u Q E L C r,
Applicant is: _ Owner X Contractor
TYPE OF WORK Description of work: £-+'b u i c. +'% 6E 4?
Construction Cost: g% d U, v C.7 Multi-Family Building: (Yes X / No ?
CONTRACTOR Name: 2 E/ £'x > La? o)2 License #: zc- ), G1 / l 3 1
Address: 1/0 S L.% ?(p c??
City: ff'I rPL S, State: /n,? Zip:
Phone: GS 2 Y3 Contact Person: D`? ?? z- ;4u/1 '2 i S
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer 8 Water Contractor: Phone:
NOTE: Plans'antl supporting documents fhaf<you submrt are'considered to be<publicinformafion: Portions of `;;
the information maybe classified as non putilic if you provide sp@cific reasons, that would permit the City to
?
=conclude;fhat.the` .-ar,elrade secrets. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the
City of
Eagan ; that I understand this is not a p it, t I' ?t? g,Q'r a permit, and wo is not [o sta ' out a permit; that the work will he in
accordance with the approved plan in the ??e`?irl?sal{I?,1?iew and approv of ans.
V
x?J,?,?; o d??eszbz; s TLPR j ? 7_OQ8 X- ApplicanYs Printed Name ApplicanYs Signature
Page 1 of 3
;. DO NOT WRITE BELOW THIS LINE. .
sue nrPes
' ? Foundation ? 05-plex ? 16-plex ? Accessory Building ? Pool
? Single Family ? 06-plex ? Fireplace ? Porch (3-season) ? Ext. Alt. - Multi
? 01 of _ Plex ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF
? 02-Plex ? 08-plex ?4D Deck ? Porch (screenlgazebo/pergola) ? Multi Misc.
? 03-Plex ? 10-plex ? Lower Level ? Storm Damage
? 04-Plex ? 12-plex ? Miscellaneous
WORK TYPES
? New ? Interior Improvement ? Siding ? Demolish Building'
? Addition ? Move Bu ilding ? Reroof ? Demolish Interior
? Alteration ? Fire Repair ? Windows ? Demolish Foundation
1Ti Replacement ? Egress Window ? Water Damage
" Demolition (entire building) - give PCA handout to applicant
DESCRIPTION:
Valuation 2?00. - Occupancy MCES System
Plan Review Code Edition Z045 "] SAC Units
(25%_ 100% ? Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Const. wdth
REQUIRED INSPECTIONS
Footings (new bldg) Sheetrock
_?o Footings (deck) Final/C.O.
_ Footings (addition) ? FinaUNo C.O.
Foundation HVAC
Drain Tile Other:
_ Roof: _Ice & Water _Final Pool: _Footings _AidGas Tests Final
_ Framing Siding: _Stucco Lath _Stone Lath _
Brick
Fireplace:_R.I. _AirTest _ Final Windows _
Insulation Retaining Wall
_
Reviewed By: M , Building Inspector
RESIDENTIAL FEES:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S8W Permit & Surcharge
Treatment Plant
Copies O? ?
Total
Page 2 of 3
IR EV oEc
Tai-?e;euiidera Inc.
?vo
r Vn5'?,( / ?
???',•Z'G'? ?'J??'27
Or.1I201
183-70
iJAc Ks ON
D SURYEYOR
0 ?'Q ,`
Rfi615TERE0 l1NDER LAWS aR S7ATE OF MIN}tE.,OTA
IJCENSED HY ORDINANCE OF CITY OF MINNP?.POL[8
3616 EAST 55TH STREET 55417 727-3484
- _ _ _ ? - urbepor'g QCettificate VACANT
SCALE ? 1" = 30'
0 DENOTES IRON
• DENOTES SPIKE
oo?'
F?
GP?PG? 9? 6
P
?
?
?6- J
. ? .
J
3? J
. 9?
? Z
000.0=Existing Elevationa
Drainage and Utility Essement;
Drainage
Praposed garage floar Elev. 95,0
and Basesent
Propased Firat Floor Elev. 103.85
I hereby certify that 6his is a true ar,d correct giat of a survey of:
Lote 9,10,11 and 12,Block 1,Brier :dili 2ad. Addition,Dakota Caunty,Minneaota.
AS SURYEYED BY ME THIS 5th. DAY OF NOY. i D 1980
.? ?
26-21-23 SIGNE '
;
F. C. JACKSON, MIHNesoTw' Istrtwnon.
i'
(
No. 3B00
r---------------
For Office Use
I .
7 4
1 Permit C
n 1
CflyofEaF
j I Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 I Date Rece' 2 4 2009
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: /1 t -to o ( Site Address: O rr, g 1z r i c~ w , „<os t C S
Tenant: 3,8 I ~ 40 (LL L e:-, Suite
RESIDENT / OWNER Name: 1 0 As 50 e, 4-,-,, o ~J ~)e Phone: -7 4, 7 - Y S y- 3'7z 7
Address / City /Zip: P- C' ij e S S~
Applicant is: Owner X Contractor
TYPE OF WORK Description of work: Q £ - v j t i'~, h f e ~
Construction Cost: Lf Multi-Family Building: (Yes X / No
CONTRACTOR Name: f3 £ f £x7-4a/eR Z.,eG, License#: ZCXq// 3 i
Address: d~c s~ L j. 6 of S:
City: In PL S, State: M-. Zip: -S'S Iyl/
Phone: 9 & 6 2 Y3 Contact Person: 1)09 4° L 64u e 2 ~ S
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
-Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that 1 understand this is not a permit, but only an application for a permit, and work-is not to sta out a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approv of ans.
X ~6j X11 b 4,ZZy2f5 x
Applicant's Printed Name Appl'icant's Signature
Page 1 of 3
3b e -
i DO NOT WRITE BELOW THIS LINE
SUB TYPES
❑ Foundation ❑ 05-plex ❑ 16-plex ❑ Accessory Building ❑ Pool
❑ Single Family ❑ 06-plex ❑ Fireplace ❑ Porch (3-season) ❑ Ext. Alt. - Multi
❑ 01 of - Plex ❑ 07-plex ❑ Garage ❑ Porch (4-season) ❑ Ext. Alt. - SF
❑ 02-Plex ❑ 08-plex 11% Deck ❑ Porch (screen/gazebo/pergola) ❑ Multi Misc.
❑ 03-Plex ❑ 10-plex ❑ Lower Level ❑ Storm Damage
❑ 04-Plex ❑ 12-plex ❑ Miscellaneous
WORK TYPES
❑ New ❑ Interior Improvement ❑ Siding ❑ Demolish Building'
❑ Addition ❑ Move Building ❑ Reroof ❑ Demolish Interior
❑ Alteration ❑ Fire Repair ❑ Windows ❑ Demolish Foundation
Replacement ❑ Egress Window ❑ Water Damage
* Demolition (entire building) - give PCA handout to applicant
DESCRIPTION: ,
Valuation C7~''C Occupancy MCES System
Plan Review Code Edition SAC Units
(25% 100% Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Const. Width
REQUIRED INSPECTIONS
Footings (new bldg) Sheetrock
x Footings (deck) Final/C.O.
-t" Footings (addition) Final/No C.O.
Foundation HVAC
Drain Tile Other:
Roof: -ice & Water -Final Pool: -Footings Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace:-R.I. -Air Test -Final Windows
Insulation Retaining Wall
Reviewed By: , Building Inspector
- - - - -
RESIDENTIAL FEES:
Base Fee ~ ~C ✓~~~G 2 / ~ CJ J
Surcharge IJ J
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Total
Page 2 of 3
REVIEWE
~To1.1efa -ildera I-nc.
183-70
A C For
DAT*~-
Na T1G1% D SURVEYOR C4, 35
BUKMW UM
REGISTERED UNDER LAWS OF STATE OF INNESOTA
LICENSED By ORDINANCE OF CITY OF M NNEAPOLIS f(~
3616 EAST 55TH STREET 551117 , 727
- 3484 ~ a J
(IV
urhtpor'g Certificate ACANT
91 _ J
g 9.17 r\.~ 2 I DPI - - _
45 13.17 v CV 2L66 21.66 9.17 cv
N V., .10 M Q
30
t B JILI ?\'F N 12,97
_
44.Q0 44.00 30 2°23p BT R
10' OF SET : 60.00 1
C\j
2° N FOV~ ! g/
N 00 N cli
13.17 rv 9~ 3A
9.17 21.66 21.66 N 'r 13.17
11 9.171
I0'OFFSET 12
~Z
9q '
000.0 = Existing Elevations
_ - - = Drainage and Utility Easements
Drainage
SCALE=I"=30' proposed garage floor Elev. 95.0
O DENOTES IRON and and Basement
DENOTES SPIKE Proposed First Floor Elev. 103.85
P~PV~ 91 6
G
P
gP
I hereby certify that t is is a true and correct plat of a survey of:
Lots 9,10,11 and 12,Block 1,Brier :fill 2nd. Addition,Dakota County, Minnesota.
AS SURYEY£D BY ME THIS 5t. DAY OF Nov. • D 1980
20-27-23 SIGNED
i
F. C. JACKSON. MINNESOTA' GISTRATION. No. 3600
PERMIT
City of Eagan Permit Type: Plumbing
3830 Pilot Knob Rd Permit Number: EA084580
Eagan, MN 55122 . Date Issued: 07/23/2008
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 3819 Laurel Ct
Lot: 10 Block: 1 Addition: Briar Hill 2nd
PID 10-14991-100-01
Use
Description:
Sub Type: e - Water Heater
Work Type: Replace
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Mike Skaja
2090 County Road 42 W.
Burnsville, MN 55337
Fee Summary: PL - Permit Fee (WS &/or WH) $50.00 0801.4087
Surcharge-Fixed $0.50 9001.2195
Total: $50.50
Contractor: - Applicant - Owner:
Tony's Appliance Claudia R Sterling
2090 County Road 42 West 3819 Laurel Ct
Burnsville MN 55337 Eagan MN 55122
(952) 435-2442
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r----
• i. For Office Usej i
MY Permit#: of Eap.
I Permit 1-ee: 1
3830 Pilot Knob (toad
Eagan MN 55122 [date Received:
Phone: (661) 6756675 I I
Fax: (651) 675.5684 I Staff: I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 4-30 --43 Site Address:38i9, 38x1, 3F 3, 3SRS" ' 4,4 &Z C. C'T. Unit
Name: fo ACT /V P4 tii 4 61 /14 Z A..) T Y~ C Phone: 7G+3 ~ s'~i 3 - 9y 70
btl or , Address City / zip: Aso tr G w "r--ti g At/ ,c3
/r1-AJ s3'vt 7
Applicant is: Owner Z_Contractor
Typ$ It Description of work: T£A-Q Off" a- QE - P4)0,0=
Cortsbttction cost Multi-Famiy Building: (Yes X' I No
Company: VAE i 6-e-P Contact ~rAviVS,-' fZA r 5
Cor i Address: //o S to 6 D'h ~!7. City: M PL S
State: /VAJ Zip: S rql 9 Phone: ~Opit ?6 i t!a.2 ~/3
. License # t'_ YI / 3 Lead Certificate
If the project is exempt from lead Certification, please explain why: (see Page 3 for additional information)
Qati&S L3r-,eC 14 'I't 7-, PDs.- 19 7 8,
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber: Phi:
Mechanical Contractor. Phone:
Sewer S Water Contractor. Phone:
; :~J.; X41: • waea r .•"$Y..i:.
CALL BEFORE YOU DIG. Cad Gopher State One Call at (651) 4544002 for protection against underground ud* damage. Cad 48 hours
before you intend to dig to receive locates of undeMramd utilities. www.oooher er,ecall.oro
1 hereby acknowledge that this inlormsfim is complete and amour* that the work will be in comVmance with the ordinances and codes of the of
Eagan; that I understand this is not a permit, but only an application for a permit. and work is not to start without a permit; that the w City of
wid be
accordance wkh the approved pran in the case of work wMM nxlulm a review and approval of plans.
Exterior work ar whad by a building permit Issued In accordance with the Minnesota State Buiidi; Code must be completed within 180
days of permit issuance.
x b1lv,N Pav22rs
Applicants Printed Name x
Applicant's Signature
Page 1 of 3
TREATED WOOD MAY REQUIRE SPECIAL.
w
AND
i ..._. - , i- (, rte: _ s
/ 1j 1 L V � r -'. '] .i
SUPPLIER FOR MORE INFORMATION.
(Ai2iiR. NJLL 1.34"4"7ES
tmoi /I PO TITEDY
s i e'itiimJ I SPECIFIC I G•
q0°1-1Cf
WALKING DACES GREATER THEN 30"
ABOVE AREA BELOW REQUIRE GUARDRAILS
MINIMUM 36" IN HEIGHT AND DESIGNED
SUCH THAT A 4" SPHERE WILL NOT PASS THROUGH
A 1L~1 zxIO
X?C�FRAirII�a
y is vzt, b4t.P• grass_
r 1x11:: Ii4M -rgiL
ictal:._ Co�JGR£.7 �
Po • 1,4 /ZEyam'
ILDING INSPECTIONS DIVISIO
*at) of Eagall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (661) 675.5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use 1 /�
Permit*: 1��
Permit Fee:
Date Received:
Staff:
J
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: - x4/- /'/ Site Address: 5019, 3 R2/, 39,1 3, 3 8„2.s- jAu2E L eY, Unit #:
Resident
Owner
Name: ek 46 1 M4.3 46ErtE.�'1- .:.c:..; C, Phone: 763 - .S s3- 9770
Address / City / Zip: RSo n E C 1 "PV 2 Av, 41. ) A 6040E.. VSE r ��
Applicant is: Owner Contractor Sr y1 7
Type'o�`:'.MVork
Description of work: 1Z14-4-0-, r_ a- R E Pr. :1-c- I/ d, 6a F-41-/ c. / a Mf ,a' L _
Construction Cost / 4 V OZ) • Cru Multi -Family Building: (Yes / No ___^)
•
Contractor
Company: {I EA &� r I 0 2 /y4i J T . ev RP. Contact b4 ✓" 0 a1122i S
Address: 4/O3- 1-i3 &,b — 1. city: /17 PL S
State: /'%^S Zip: . '// 9 Phone: to/ Z • ' % I- La 2 V 3
License #: 41 L 2V// 3 / Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
ill-NeD5- Q,4,-7-' Pos:- /7-7
In the last 12 months,
Yes _No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan Issued a permit for a similar plan based on a master plan?
yes. date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
NO.TE:' Pn� YRI.Y.. QI tinge,M.MMiIIetto jjh Me"rWi-� 4���i•P�
ITyI�!'� you I9li
�j�� ,,ice �y/��p.. .. 1 r.. yy���y�y��+�p� /,� keit '��
atforr.' its ..
C./ 1 ,'hgy�pp r
'.1
�:4�
CALL BEFORE YOU DIG. can Gopher State Ono Cali at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. www.aooherstateonoeall_orq
I hereby acknowledge that this information Is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan: that I understand this Is not a permit, but only en application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans,
Exterior work authorized by a building permit 'issued in accordance with the Minnesota State Bu11dlnLCode must be completed within 180
days of permit Issuance.
x 4" 0 fi /2.14
Applicant's Printed Name
90/90 39Cd
x.
Applicants Signature
7 g
Page 1 of 3
1NICW 1X3 I3g L9Z9T98ZT9 SS:TT VTOZ/UZ/80
Use BLUE or BLACK Ink
For Office Use �,(�Permit#: I t( ✓-1
CitY of Eakan Permit Fee: /4"e"9
3830 Pilot Knob Road . a
Eagan MN 55122 Date Received:
Phone:(651)675-5675 RECEIVED �' +
Fax:(651)675-5694 Staff:
APR 302017
2017 RESIDENT' I BUILDING PERMIT APPLICATION
Date: 0/42-11..260-Site Address: 0 1C/ N Unit#:
Name: lf'c,r 4- (S -f .e- c ,xr�"c ta:0..Ya` Phone:q5).-S5-4 - (o 51
Resident/ I
Owner Address/City/Zip: 315/1 Luwt I C f- /CcrS -, (' 5-‘37,„,1- 3
PI)Applicant is: Owner lC Contractor
Description of work: Covtcre4-e,. 5X213 Agcs+es
Type of Work
Construction Costffi/c ua - a S1orS?t-..'l.';i7y Multi-Family Building:(Yes k 1 No )
Company: ---770 S GK,( ?4414.eN c Contact: Kyk --73-43(v)�t ow
� 5
Address: I ir1r'� ktc4,t 1Jctne, (3L�c. City: T.ni-t - Cz'iteve.'t(e c'*kit'S
Contractor y
State:/tiWltl Zip:5',a}} Phone: ors-a-Si 5-in?. Email: k•onn.tn#t. 0"/NticEtG4trtenw.•
sLicense#: G 1(D(�$ Lead Certificate#:
If the project is exempt from lead certification, please explain why:
N Ot-
..�..w.v.-n......«..-.„.........«...�.�........ -., .......,.w.w e.w.....m..—..v - ....a......,...... ....... .._... .. a-....-w.w....�...-._......_».,.�.m....«., ,v,,,e...............«.......,....., —
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
• _Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor; Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor. Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.000herstateonecall.orq
I hereby acknowledge that this information is complete and accurate:that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x 111
Applicaht's Printed Name Applijt Signature
Page 1 of 3
DO� NOT WRITE BELOW THIS LINE t 4 /4139 1 c
SUB TYPES 3Op1g 4-- 3gg 3 L C-e, j -`
Fouridation Fireplace Porch (3-Season) Exterior Alteration(Single Family)
Single Family Garage Porch (4-Season) Exterior Alteration (Multi)
Multi Deck Porch (Screen/Gazebo/Pergola) Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
Addition Move Building Reroof Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
tic Replace _ Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation dif 0 pvc,• '- Occupancy 1 oc-~3 MCES System
Plan Review Code Edition ,1 2®/5 SAC Units
(25% )0 100%_) Zoning ' P City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction V pj Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final I C.O. Required
Footings (Addition) O Final I No C.O. Required
70 Foundation Foundation Before Backfill HVAC Gas Service Test Gas Line Air Test
Roof: _Ice &Water Final Pool: Footings _Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In Air Test Final Siding: Stucco Lath Stone Lath Brick_EFIS
Insulation Windows
Sheathing Retaining Wall: Footings_ Backfill—Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: `l 0011 ft7 14.1114 , Building Inspector
RESIDENTIAL FEES -y-% 01 t.)'D,e 5 -,R -b Pte; (
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC /nht-Siert. 00/42i7 Fe J i e %--) I. Q
'E
Utility Connection Charge /- nT .-t>a
S&W Permit& Surcharge
Treatment Plant
/a - ,f; j Z S//b
Copies
TOTAL
Page 2 of 3